Mitral valve repair with the edge-to-edge technique: A 20 years single-center experience.

Tytuł:: Mitral valve repair with the edge-to-edge technique: A 20 years single-center experience.
Autorzy:: Sideris K; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Burri M; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Prinzing A; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Voss S; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Krane M; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Guenzinger R; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Lange R; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Voss B; Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Lazarettstrasse, Munich, Germany.
Źródło:: Journal of cardiac surgery [J Card Surg] 2021 Apr; Vol. 36 (4), pp. 1298-1304. Date of Electronic Publication: 2021 Jan 29.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Hoboken, NJ : Wiley-Blackwell
Original Publication: Mount Kisco, N.Y. : Futura Pub. Co., Inc., [c1986-
MeSH Terms:: Mitral Valve Annuloplasty*
Mitral Valve Insufficiency*/diagnostic imaging
Mitral Valve Insufficiency*/surgery
Mitral Valve Prolapse*/diagnostic imaging
Mitral Valve Prolapse*/surgery
Aged ; Humans ; Middle Aged ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Retrospective Studies ; Treatment Outcome
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Contributed Indexing:: Keywords: heart valve surgery; mitral valve surgery; outcomes (includes mortality, morbidity)
Entry Date(s):: Date Created: 20210129 Date Completed: 20210510 Latest Revision: 20221012
Update Code:: 20240104
DOI:: 10.1111/jocs.15377
PMID:: 33512725
: Czasopismo naukowe

Pełny tekst

Objectives: For tailored treatment of primary mitral regurgitation (MR), surgeons developed different repair techniques. One of them, the edge-to-edge repair has recently seen a revival, especially for Barlow's disease.
Methods: This study was designed to assess the outcomes of the edge-to-edge technique in mitral valve (MV) repair. Preoperative, periprocedural, and postoperative data were prospectively collected in a dedicated database and analyzed retrospectively.
Results: Between March 1999 and July 2019, a total of 152 patients (mean age: 60 ± 13) received an edge-to-edge repair combined with annuloplasty for degenerative MR at our institution. MR resulted from posterior leaflet prolapse in 23 patients (15.1%), anterior leaflet prolapse in 19 (12.5%), and bileaflet prolapse in 110 (72.4%). Of those who had a bileaflet prolapse, 91 (82.7%) had Barlow's disease. Follow-up was complete in 97.4% (6.4 ± 5.7 years). Echocardiographic assessment was achieved in 85.5% (5.1 ± 5.6 years). Overall survival after 10 years was 73.7 ± 5.0%. Twelve patients required valve-related reoperations due to ring dehiscence (n = 2), leaflet suture dehiscence (n = 2), progression of native valve disease (n = 6), or due to device failure (ring fracture) (n = 2). The cumulative incidence of valve-related reoperation at 10 years was 8.4 ± 3.0% (5.2 ± 4.1% in patients with Barlow's disease). At latest follow-up, echocardiography revealed excellent valve function with no or mild MR in 93 patients (88.6%). The mean gradient was 2.9 ± 1.3 mmHg at discharge and decreased to 2.4 ± 1.3 mmHg. Three patients (2.8%) had more than moderate MR.
Conclusion: Edge-to-edge MV repair is a simple method with excellent results in terms of valvular function and durability especially in patients with Barlow's disease.
(© 2021 The Authors. Journal of Cardiac Surgery Published by Wiley Periodicals LLC.)

Comment in: J Card Surg. 2022 Nov;37(11):4016-4017. (PMID: 35989495)

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